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Patentes

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Número de publicaciónUS20110184405 A1
Tipo de publicaciónSolicitud
Número de solicitudUS 12/692,414
Fecha de publicación28 Jul 2011
Fecha de presentación22 Ene 2010
Fecha de prioridad22 Ene 2010
También publicado comoEP2347725A1, US8480671, US9113906, US20130296854, US20150327917
Número de publicación12692414, 692414, US 2011/0184405 A1, US 2011/184405 A1, US 20110184405 A1, US 20110184405A1, US 2011184405 A1, US 2011184405A1, US-A1-20110184405, US-A1-2011184405, US2011/0184405A1, US2011/184405A1, US20110184405 A1, US20110184405A1, US2011184405 A1, US2011184405A1
InventoresPeter M. Mueller
Cesionario originalTyco Healthcare Group Lp
Exportar citaBiBTeX, EndNote, RefMan
Enlaces externos: USPTO, Cesión de USPTO, Espacenet
Compact Jaw Including Split Pivot Pin
US 20110184405 A1
Resumen
An end effector assembly for use with a forceps includes a pair of jaw members, a knife assembly, and one or more cam assemblies. One or more of the jaw members are moveable relative to the other about a pivot between open and closed positions. One or more of the jaw members include a knife channel. The pivot includes first and second sections defining a passage therebetween. The knife assembly includes a knife blade and an actuation shaft. The knife blade is disposed distally relative to the pivot. The actuation shaft is configured for slidable translation through the passage to allow selective advancement of the knife blade through the knife channel. The one or more cam assemblies are operably coupled to the one or more moveable jaw members and are actuatable to move the one or more jaw members between the open and closed positions for grasping tissue therebetween.
Imágenes(16)
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Reclamaciones(19)
1. An end effector assembly for use with a forceps, the end effector assembly comprising:
a pair of jaw members, at least one jaw member moveable relative to the other about a pivot between an open position and a closed position for grasping tissue, at least one of the jaw members including a knife channel defined therein that extends therealong, the pivot having first and second sections defining a passage therebetween;
a knife assembly including a knife blade and an actuation shaft, the knife blade disposed distally relative to the pivot and the actuation shaft configured for slidable translation through the passage defined between the first and second sections of the pivot to allow selective advancement of the knife blade through the knife channel; and
at least one cam assembly operably coupled to the at least one moveable jaw member and actuatable to move the at least one jaw member between the open and the closed position for grasping tissue therebetween.
2. The end effector assembly according to claim 1, wherein the at least one cam assembly includes an actuator configured to move the at least one movable jaw member between the open and the closed position upon selective longitudinal translation thereof.
3. The end effector assembly according to claim 2, wherein the actuator includes at least one cam pin extending therefrom and wherein at least one jaw member defines at least one cam slot therein such that the at least one cam slot and the at least one cam pin are configured to cooperate with one another to move the at least one moveable jaw member.
4. The end effector assembly according to claim 3, further comprising a knife tube mounted to the pivot wherein the at least one cam pin is configured to slidably engage the knife tube upon the selective longitudinal translation of the actuator.
5. The end effector assembly according to claim 4, wherein the knife tube defines a recess adapted to mount each of the first and second sections of the pivot at the distal ends thereof, the distal ends of each of the first and second sections defining a profile configured to engage the recess.
6. The end effector assembly according to claim 2, further comprising an actuator tube operably associated with the forceps which is configured to longitudinally translate the actuator and permit the slidable translation of the actuation shaft therethrough.
7. The end effector assembly according to claim 6, further including a roll joint operably coupled to the actuator tube and configured to facilitate rotational movement of the jaw members.
8. The end effector assembly according to claim 2, wherein the actuator is moveable to actuate both jaw members.
9. The end effector assembly according to claim 1, wherein the knife blade is affixed to a distal end of the actuation shaft.
10. The end effector assembly according to claim 1, wherein at least one of the jaw members is adapted to connect to an electrosurgical energy source to electrosurgically treat tissue.
11. A forceps, comprising:
a housing having a shaft that extends therefrom that includes a clevis at a distal end thereof;
a pair of jaw members mounted to the clevis about a pivot, at least one jaw member moveable relative to the other about the pivot between an open position and a closed position for grasping tissue, at least one of the jaw members including a knife channel defined therein that extends therealong, the pivot having first and second sections defining a passage therebetween;
a knife assembly including a knife blade and an actuation shaft, the knife blade disposed distally relative to the pivot and the actuation shaft configured for slidable translation through the passage defined between the first and second sections of the pivot to allow selective advancement of the knife blade through the knife channel;
at least one cam assembly operably coupled to the at least one moveable jaw member and actuatable to move the at least one jaw member between the open and the closed position for grasping tissue therebetween, wherein the at least one cam assembly includes an actuator operably coupled to the housing, wherein the actuator includes at least one cam pin extending therefrom and wherein at least one jaw member defines at least one cam slot therein such that the at least one cam slot and the at least one cam pin are configured to cooperate with one another to move the at least one moveable jaw member; and
a knife tube mounted to the pivot wherein the at least one cam pin is configured to slidably engage the knife tube upon the selective longitudinal translation of the actuator.
12. The forceps according to claim 11, wherein the actuator is configured to move the at least one jaw member between the open and the closed position upon selective longitudinal translation thereof.
13. The forceps according to claim 11, wherein the knife tube defines a recess adapted to mount each of the first and second sections of the pivot at the distal ends thereof, the distal ends of each of the first and second sections defining a profile configured to engage the recess.
14. The forceps according to claim 11, wherein the shaft of the housing includes an actuator tube that is configured to longitudinally translate the actuator and permit the slidable translation of the actuation shaft therethrough.
15. The end effector assembly according to claim 14, further including a roll joint operably coupled to the actuator tube and configured to facilitate rotational movement of the jaw members.
16. The forceps according to claim 11, wherein the actuator is moveable to actuate both jaw members.
17. The forceps according to claim 11, wherein the knife blade is affixed to a distal end of the actuation shaft.
18. The forceps according to claim 11, wherein at least one of the jaw members is adapted to connect to an electrosurgical energy source to electrosurgically treat tissue.
19. The forceps according to claim 11, wherein the first and second sections of the pivot are fixedly connected to the clevis.
Descripción
    BACKGROUND
  • [0001]
    1. Technical Field
  • [0002]
    The present disclosure relates to an apparatus for performing an endoscopic electrosurgical procedure. More particularly, the present disclosure relates to an apparatus for performing an endoscopic electrosurgical procedure that employs an endoscopic electrosurgical apparatus that includes an end effector assembly configured for use with variously-sized access ports.
  • [0003]
    2. Description of Related Art
  • [0004]
    Electrosurgical apparatuses (e.g., electrosurgical forceps) are well known in the medical arts and typically include a handle, a shaft and an end effector assembly operatively coupled to a distal end of the shaft that is configured to manipulate tissue (e.g., grasp and seal tissue). Electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect homeostasis by heating the tissue and blood vessels to coagulate, cauterize, fuse, seal, cut, desiccate, and/or fulgurate tissue.
  • [0005]
    As an alternative to open electrosurgical forceps for use with open surgical procedures, many modern surgeons use endoscopes and endoscopic electrosurgical apparatus (e.g., endoscopic forceps) for remotely accessing organs through smaller, puncture-like incisions. As a direct result thereof, patients tend to benefit from less scarring, less pain, and reduced healing time. Typically, the endoscopic forceps are inserted into the patient through one or more various types of cannulas or access ports (typically having an opening that ranges from about five millimeters to about fifteen millimeters) that has been made with a trocar; as can be appreciated, smaller cannulas are usually preferred.
  • [0006]
    Endoscopic forceps that are configured for use with small cannulas (e.g., cannulas less than five millimeters) may present design challenges for a manufacturer of endoscopic instruments.
  • SUMMARY
  • [0007]
    Accordingly, an end effector assembly for use with a forceps includes a pair of jaw members, a knife assembly, and one or more cam assemblies. One or both of the jaw members are moveable relative to the other about a pivot between an open position and a closed position for grasping tissue. One or both of the jaw members include a knife channel defined therein that extends therealong. In embodiments, one or both jaw members are adapted to connect to an electrosurgical energy source to electrosurgically treat tissue. The pivot has first and second sections defining a passage therebetween.
  • [0008]
    The knife assembly includes a knife blade and an actuation shaft. The knife blade may be affixed to a distal end of the actuation shaft. The knife blade is disposed distally relative to the pivot. The actuation shaft is configured for slidable translation through the passage defined between the first and second sections of the pivot to allow selective advancement of the knife blade through the knife channel.
  • [0009]
    The one or more cam assemblies are operably coupled to the one or more moveable jaw members and are actuatable to move one or both jaw members between the open and the closed position for grasping tissue therebetween. The one or more cam assemblies include an actuator configured to move each movable jaw member between the open and the closed position upon selective longitudinal translation thereof. The actuator may be moveable to actuate both jaw members. The actuator includes one or more cam pins extending therefrom. One or both jaw members define one or more cam slots therein such that the one or more cam slots and the one or more cam pins are configured to cooperate with one another to move each moveable jaw member. An actuator tube is operably associated with the forceps which is configured to longitudinally translate the actuator and permit the slidable translation of the actuation shaft therethrough. In one embodiment, a roll joint is operably coupled to the actuator tube and is configured to facilitate rotational movement of the jaw members.
  • [0010]
    The end effector assembly includes a knife tube mounted to the pivot wherein the one or more cam pins are configured to slidably engage the knife tube upon the selective longitudinal translation of the actuator. The knife tube defines a recess adapted to mount each of the first and second sections of the pivot at the distal ends thereof. The distal ends of each of the first and second sections define a profile configured to engage the recess.
  • [0011]
    According to another aspect, a forceps includes a housing, a pair of jaw members, a knife assembly, and one or more cam assemblies. The housing has a shaft that extends therefrom that includes a clevis at a distal end thereof. The shaft of the housing includes an actuator tube.
  • [0012]
    The pair of jaw members are mounted to the clevis about a pivot. One or both jaw members are moveable relative to the other about the pivot between an open position and a closed position for grasping tissue. One or both of the jaw members include a knife channel defined therein that extends therealong. One or both of the jaw members may be adapted to connect to an electrosurgical energy source to electrosurgically treat tissue. The pivot has first and second sections defining a passage therebetween. In embodiments, the first and second sections of the pivot are fixedly connected to the clevis.
  • [0013]
    The knife assembly includes a knife blade and an actuation shaft. The knife blade may be affixed to a distal end of the actuation shaft. The knife blade is disposed distally relative to the pivot. The actuation shaft is configured for slidable translation through the passage defined between the first and second sections of the pivot to allow selective advancement of the knife blade through the knife channel.
  • [0014]
    The one or more cam assemblies are operably coupled to each moveable jaw member and are actuatable to move one or both jaw members between the open and the closed position for grasping tissue therebetween. One or more cam assemblies include an actuator operably coupled to the housing that is configured to move one or both jaw members between the open and the closed position upon selective longitudinal translation thereof. The actuator may be moveable to actuate both jaw members. The actuator includes one or more cam pins extending therefrom. One or both jaw members define one or more cam slots therein such that the one or more cam slots and the one or more cam pins are configured to cooperate with one another to move each moveable jaw member. The actuator tube is configured to longitudinally translate the actuator and permit the slidable translation of the actuation shaft therethrough.
  • [0015]
    The forceps includes a knife tube mounted to the pivot. The one or more cam pins are configured to slidably engage the knife tube upon the selective longitudinal translation of the actuator. The knife tube defines a recess adapted to mount each of the first and second sections of the pivot at the distal ends thereof. The distal ends of each of the first and second sections define a profile configured to engage the recess.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0016]
    The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:
  • [0017]
    FIG. 1A is a top, perspective view of an endoscopic forceps shown in an open configuration and including a housing, a handle assembly, a shaft and an end effector assembly according to the present disclosure;
  • [0018]
    FIG. 1B is a top, perspective view of the endoscopic forceps of FIG. 1A showing the end effector assembly in a closed configuration according to the present disclosure;
  • [0019]
    FIG. 2A is an enlarged, top view of the forceps of FIG. 1A showing the disposition of the internal components when the forceps is in an open configuration;
  • [0020]
    FIG. 2B is an enlarged, top view of the forceps of FIG. 1B showing the disposition of the internal components when the forceps is in a closed configuration;
  • [0021]
    FIG. 3A is an enlarged, top view showing the knife actuator after actuation;
  • [0022]
    FIG. 3B is a greatly-enlarged, side cross sectional view of the end effector assembly showing the position of the knife after actuation;
  • [0023]
    FIG. 4A is a greatly-enlarged, perspective view of the bottom jaw of the end effector assembly with parts separated;
  • [0024]
    FIG. 4B is a greatly-enlarged, perspective view of the top jaw of the end effector assembly with parts separated;
  • [0025]
    FIG. 5 is a greatly-enlarged, perspective view of the elongated shaft for housing various moving parts of the drive assembly and knife assembly;
  • [0026]
    FIG. 6 is a partially exploded, perspective view of the end effector assembly;
  • [0027]
    FIG. 7 is a top view of the end effector assembly with the upper jaw member removed;
  • [0028]
    FIG. 8 is a rear, perspective view of one of the jaw members in accordance with an alternate embodiment of the present disclosure;
  • [0029]
    FIG. 9 is right, rear, perspective view of an end effector assembly shown in a first position according to one embodiment of the present disclosure;
  • [0030]
    FIG. 10 is a left, perspective view of the end effector assembly of FIG. 9 with the top jaw thereof removed for clarity and with a clevis thereof shown in phantom;
  • [0031]
    FIG. 11 is a right, perspective view of FIG. 10 with a proximal portion of the bottom jaw removed for clarity;
  • [0032]
    FIG. 12 is a right, perspective view of FIG. 11 illustrating a second position of the end effector assembly of FIG. 9; and
  • [0033]
    FIG. 13 is a right, perspective view of one embodiment of an end effector assembly.
  • DETAILED DESCRIPTION
  • [0034]
    Detailed embodiments of the present disclosure are disclosed herein; however, the disclosed embodiments are merely exemplary of the disclosure, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure.
  • [0035]
    As noted above, it may prove useful in the arts to provide an electrosurgical apparatus that is suitable for use with various access ports, including but not limited to those that are greater than and/or less than five millimeters. With this purpose in mind, the present disclosure includes an electrosurgical forceps that includes a drive assembly operatively coupled to one or more jaw members associated with the end effector assembly of the electrosurgical forceps. The drive assembly is configured to move the jaw members from an open to a closed configuration such that when actuated, the jaw members form a closed loop electrical circuit such that a desired tissue effect (e.g., tissue seal) may be achieved.
  • [0036]
    Turning now to FIGS. 1A and 1B, one embodiment of an electrosurgical forceps 10 is shown for use with various surgical procedures and generally includes a housing 20, a handle assembly 30, a rotating assembly 80, a knife trigger assembly 70 and an end effector assembly 100 which mutually cooperate to grasp, seal and divide tubular vessels and vascular tissue. Although the majority of the figure drawings depict a forceps 10 for use in connection with endoscopic or laparoscopic surgical procedures, the present disclosure may be used for more traditional open surgical procedures. For the purposes herein, the forceps 10 is described in terms of an endoscopic or laparoscopic instrument; however, it is contemplated that an open version of the forceps may also include the same or similar operating components and features as described below.
  • [0037]
    Forceps 10 includes a shaft 12 that has a distal end 16 dimensioned to mechanically engage the end effector assembly 100 and a proximal end 14 that mechanically engages the housing 20. Details of how the shaft 12 connects to the end effector assembly 100 are described in more detail below. The proximal end 14 of shaft 12 is received within the housing 20 and the connections relating thereto are also described in detail below. In the drawings and in the descriptions that follow, the term “proximal”, as is traditional, will refer to the end of the forceps 10 that is closer to the user, while the term “distal” will refer to the end that is farther from the user.
  • [0038]
    Forceps 10 also includes an electrosurgical cable 310 that may be internally divided into two or more leads which may connect the forceps 10 to a source of electrosurgical energy, e.g., a generator. Generators such as those sold by Covidien, located in Boulder, Colo. may be used as a source of both bipolar electrosurgical energy for sealing vessel and vascular tissues as well as monopolar electrosurgical energy which is typically employed to coagulate or cauterize tissue. It is envisioned that the generator may include various safety and performance features including isolated output, impedance control and/or independent activation of accessories.
  • [0039]
    Handle assembly 30 includes two movable handles 30 a and 30 b disposed on opposite sides of housing 20. Handles 30 a and 30 b are movable relative to one another to actuate the end effector assembly 100 as explained in more detail below with respect to the operation of the forceps 10.
  • [0040]
    Rotating assembly 80 is mechanically coupled to housing 20 and is rotatable approximately 90 degrees in either direction about a longitudinal axis “A.” Rotating assembly 80, when rotated, rotates shaft 12, which, in turn, rotates end effector assembly 100. Such a configuration allows end effector assembly 100 to be rotated approximately 90 degrees in either direction with respect to housing 20.
  • [0041]
    As mentioned above, end effector assembly 100 is attached at the distal end 16 of shaft 12 and includes a pair of opposing jaw members 110 and 120 (see FIG. 6). Handles 30 a and 30 b of handle assembly 30 ultimately connect to drive assembly 60 (see FIG. 2A) which, together, mechanically cooperate to impart movement of the jaw members 110 and 120 from a first, open position wherein the jaw members 110 and 120 are disposed in spaced relation relative to one another, to a second, clamping or closed position wherein the jaw members 110 and 120 cooperate to grasp tissue therebetween.
  • [0042]
    Turning now to the more detailed features of the present disclosure as described with respect to FIGS. 1A-8, handles 30 a and 30 b each include an aperture 33 a and 33 b, respectively, defined therein which enables a user to grasp and move each respective handle 30 a and 30 b relative to one another. Handles 30 a and 30 b also include ergonomically-enhanced gripping elements 39 a and 39 b, respectively, disposed along an outer edge thereof which are designed to facilitate gripping of the handles 30 a and 30 b during activation. It is envisioned that gripping elements 39 a and 39 b may include one or more protuberances, scallops and/or ribs to enhance gripping.
  • [0043]
    As best illustrated in FIG. 1A, handles 30 a and 30 b are configured to extend outwardly on opposite sides from a transverse axis “B” defined through housing 20 which is perpendicular to longitudinal axis “A”. Handles 30 a and 30 b are movable relative to one another in a direction parallel to axis “B” to open and close the jaw members 110 and 120 as needed during surgery. Details relating to the inner-working components of forceps 10 are disclosed in commonly-owned U.S. patent application Ser. No. 11/540,335. This forceps style is commonly referred to as an “in-line” or hemostat style forceps. In-line hemostats or forceps are more commonly manufactured for open surgical procedures and typically include a pair of shafts having integrally coupled handles which are movable relative to one another to open and close the jaw members disposed at the distal end thereof.
  • [0044]
    As best seen in FIGS. 2A and 2B, the distal end of each handle 30 a and 30 b is selectively moveable about pivot pins 34 a and 34 b attached to a distal end 21 of the housing 20 to actuate the jaw members 110 and 120. Movement of the handles 30 a and 30 b away from one another (and the housing 20) unlocks and opens the handles 30 a and 30 b and, in turn, the jaw members 110 and 120 for subsequent grasping or re-grasping of tissue. In one embodiment, the handles 30 a and 30 b may be biased in an open configuration to facilitate handling and manipulation of the jaws within an operative field. Various spring-like mechanisms are contemplated which may be utilized to accomplish this purpose.
  • [0045]
    Movable handles 30 a and 30 b are designed to provide a distinct lever-like mechanical advantage over conventional handle assemblies. The enhanced mechanical advantage for actuating the jaw members 110 and 120 is gained by virtue of the unique position and combination of several inter-cooperating elements which reduce the overall user forces necessary to obtain and maintain the jaw members 110 and 120 under ideal operating pressures of about 3 kg/cm2 to about 16 kg/cm2. Details relating to the working components the handle assembly and drive assembly are disclosed in above-mentioned U.S. patent application Ser. No, 11/540,335. In other words, it is envisioned that the combination of these elements and their positions relative to one another enables the user to gain lever-like mechanical advantage to actuate the jaw members 110 and 120 enabling the user to close the jaw members 110 and 120 with lesser force while still generating the required forces necessary to effect a proper and effective tissue seal.
  • [0046]
    As shown best in FIGS. 4A, 4B, 5 and 6, the end effector assembly 100 is designed as a bilateral assembly, i.e., both jaw members 110 and 120 pivot relative to one another about a pivot pin 185 disposed therethrough. A unilateral end effector assembly is also envisioned. End effector assembly 100 further includes a knife guide 133 that houses the knife blade 190 for translation therethrough. Knife guide 133 is assembled with flanges 113 and 123 to allow pivotable movement of the flanges 113 and 123 about a pivot pin 185 disposed between the jaw members 110 and 120 upon translation of a drive pin 180 as explained in more detail below.
  • [0047]
    More particularly, jaw members 110 and 120 include proximal flanges 113 and 123, respectively, which each include an elongated angled slot 181 a and 181 b, respectively, defined therethrough. Drive pin 180 mounts jaw members 110 and 120 and knife guide 133 to the end of a rotating shaft 18 and within a cavity 17′ defined at the distal ends 17 a and 17 b of drive actuator or sleeve 17 (See FIG. 5). Knife guide 133 includes an elongated slot 181 c defined therethrough, configured for accepting the drive pin 180 and for allowing translation of the drive pin 180 within slots 181 a-181 c, which pivots the jaw members 110 and 120 relative to one another for grasping tissue. Knife guide 133 may also provide a unique safety feature for the forceps 10 as described in more detail below.
  • [0048]
    Upon actuation of the drive assembly 60, the drive sleeve 17 reciprocates which, in turn, causes the drive pin 180 to ride within slots 181 a and 181 b to open and close the jaw members 110 and 120 as desired and similarly causes the drive pin 180 to ride within slot 181 c of knife guide 133. The jaw members 110 and 120, in turn, pivot about pivot pin 185 disposed through respective pivot holes 186 a and 186 b defined within flanges 113 and 123, the jaw members 110 and 120 and hole 186 c disposed within knife guide 133. Upon actuation, knife guide 133 remains oriented in alignment with the shaft 12 as the jaws move about pivot pin 185 (See FIG. 6). As can be appreciated, squeezing handles 30 a and 30 b toward the housing 20 pulls drive sleeve 17 and drive pin 180 proximally to close the jaw members 110 and 120 about tissue grasped therebetween and pushing the sleeve 17 distally opens the jaw members 110 and 120 for grasping purposes.
  • [0049]
    Flanges 113 and 123 of jaw members 110 and 120, respectively, are positioned in an abutting relationship with one another and knife guide 133 is positioned adjacent to flanges 113 and 123. Flanges 113, 123 and knife guide 133 are assembled and engaged via pivot pin 185 disposed through apertures 186 a, 186 b, and 186 c, respectively. Further, flanges 113, 123 are pivotable about one another via drive pin 180 disposed through slots 181 a and 181 b and of flanges 113, 123, respectively. A knife path 138 may be defined between flange 113 and knife guide 133, as shown in FIGS. 6 and 7. The knife path 138 longitudinally aligns with knife channels 115 a and 115 b defined within jaw members 110 and 120, such that knife blade 190 travels in a substantially straight path through knife path 138 and, further, through knife channels 115 a and 115 b.
  • [0050]
    Alternatively, the orientation of flanges 113 and 123 may be reversed, with knife path 138 being defined between flange 123 and blade guide 133. In contrast to prior known designs, the abutting relationship between flanges 113 and 123 (in either orientation) strengthens the jaw flanges 113 and 123 since a blade path or blade channel does not need to be defined therebetween but, rather, is defined on an exterior side of one of the flanges 113 and 123. Thus, the knife 190 travels between the blade guide 133 and the flanges 113 and 123 and not between flanges. By manufacturing the knife path 138 on either side of the flanges 113 and 123, jaw splay may also be more easily controlled and tighter tolerances may be employed during the manufacturing process, thereby allowing tighter tolerances on certain features of the jaw member 110 and 120 resulting in better overall performance.
  • [0051]
    For example, the knife channels 115 a and 115 b defined within the jaw members 110 and 120, respectively, may be more precisely aligned with less splay between the jaw members 110 and 120, thereby facilitating knife blade 190 translation. Moreover, the strength of the flanges 113 and 123 is enhanced as well as the union therebetween, e.g., flat-on-flat abutting flange surfaces have more surface contact making the union therebetween stronger. The knife guide 133 may also be configured to pre-load jaw members 110 and 120 to help ensure proper alignment of knife channel halves 115 a and 115 b upon closing of the jaw members 110 and 120 as explained in more detail below.
  • [0052]
    As best shown in FIG. 6, blade guide 133 may include a blade stop or hook 135 disposed at a distal end thereof. The blade stop 135 may be integrally associated with the knife guide 133 (FIG. 6), the purpose of which is explained immediately below, or pivotably engaged with the knife guide 133, the purpose of which is explained with reference to FIG. 9. The relationship between flanges 113 and 123 and blade guide 133 is established by pivot pin 185 disposed through apertures 186 a, 186 b, and 186 c, respectively, and by drive pin 180 disposed through slots 181 a, 181 b and 181 e, respectively. Accordingly, when jaw members 110, 120 are in a first, or open, position, knife guide 133 pivots such the blade stop 135 interferes with the knife path 138, thereby preventing distal translation of knife blade 190. In one embodiment, this may be accomplished by the knife guide 133 including an elongated slot 181 c that is cammed when the drive pin 180 is biased in a distal-most position such that the knife guide 133 and blade stop 135 pivot thereby obstructing the knife path 138.
  • [0053]
    When handles 30 a and 30 b are squeezed toward the housing 20, drive sleeve 17 and drive pin 180 are pulled proximally to close the jaw members 110 and 120, which also pivots the knife guide 133 so that the blade stop 135 no longer obstructs or interferes with the knife path 138. Thus, in this embodiment, the knife guide 133, by virtue of the blade stop 135, prevents distal advancement of knife blade 190 when jaw members 110 and 120 are in the first, open position and permits distal advancement of knife blade 190 when jaw members 110 and 120 are in the second, closed position.
  • [0054]
    Alternatively, a hook (not shown) may be disposed on either of flanges 113 or 123. The hook would operate in substantially the same manner as the blade stop 135 disposed on the blade guide 133 in the embodiment discussed above. Accordingly, as jaw members 110, 120 are opened, the hook on flange 113 or 123 is pivoted into the path of knife blade 190, thereby preventing distal translation of knife blade 190. When handles 30 a and 30 b are squeezed toward the housing 20, drive sleeve 17 and drive pin 180 are pulled proximally to close the jaw members 110 and 120. The pulling of drive pin 180 also pivots flanges 113 and 123, thereby closing the jaw members 110 and 120 and as a result, the hook is pivoted out of the path of knife blade 190.
  • [0055]
    As best shown in FIG. 4B, jaw member 110 also includes a support base 119 that extends distally from flange 113 and that is configured to support an insulative plate 119′ thereon. Insulative plate 119′, in turn, is configured to support an electrically conductive tissue engaging surface or sealing plate 112 thereon. Sealing plate 112 may be affixed atop the insulative plate 119′ and support base 119 in any suitable manner, e.g., snap-fit, over-molding, stamping, ultrasonically welded, etc. Support base 119 together with the insulative plate 119′ and electrically conductive tissue engaging surface 112 are encapsulated by an outer insulative housing 114. Outer housing 114 includes a cavity 114 a that is dimensioned to securely engage the electrically conductive sealing surface 112 as well as the support base 119 and insulative plate 119′. This may be accomplished by stamping, by overmolding, by overmolding a stamped electrically conductive sealing plate and/or by overmolding a metal injection molded seal plate. All of these manufacturing techniques produce jaw member 110 having an electrically conductive surface 112 that is substantially surrounded by an insulating substrate 114.
  • [0056]
    The electrically conductive surface or sealing plate 112 and the outer housing 114, when assembled, form longitudinally-oriented knife channel 115 a defined therethrough for reciprocation of the knife blade 190. It is envisioned that the knife channel 115 a cooperates with corresponding knife channel 115 b defined in jaw member 120 to facilitate longitudinal extension of the knife blade 190 along a preferred cutting plane to effectively and accurately separate the tissue along the formed tissue seal. As discussed above, when knife blade 190 is deployed, at least a portion of knife blade 190 advances through knife path 138 and into knife channels 115 a and 115 b. In addition to the blade stop 135, handle 30 a may includes a lockout flange (not shown) which prevents actuation of the knife assembly 70 when the handle 30 a is open thus preventing accidental or premature activation of the knife blade 190 through the tissue. A more detailed discussion of the lockout flange is discussed in above-mentioned U.S. patent application Ser. No. 11/540,335.
  • [0057]
    As explained above and as illustrated in FIGS. 4A and 4B, in one embodiment, the knife channel 115 is formed when the jaw members 110 and 120 are closed. In other words, the knife channel 115 includes two knife channel halves—knife channel half 115 a disposed in sealing plate 112 of jaw member 110 and knife channel half 115 b disposed sealing plate 122 of jaw member 120. It is envisioned that the knife channel 115 may be configured as a straight slot with no degree of curvature which, in turn, causes the blade 190 to move through the tissue in a substantially straight fashion. Alternatively, and as shown, the knife channel 115 may be curved, which has certain surgical advantages. In the particular embodiment shown in FIGS. 6 and 7, the knife channel 115 (knife channel 115 a shown) is curved and is offset from the centerline or longitudinal axis “A” of the forceps 10 by a distance “X” (See FIGS. 7 and 8). This offset distance “X” may be in the range of about 0.010 inches to about 0.040 inches.
  • [0058]
    The offset orientation of the knife blade 190 (by virtue or the knife guide 133 being assembled on one side of the flanges 113 and 123 allows the knife blade to enter the knife channel 115 in a substantially straight orientation thereby facilitating separation of tissue. Moreover, the knife blade 190 travels in a substantially straight manner through most of the knife channel 115 and is only forced to bend around the knife channel 115 towards a distal end of the jaw members 110 and 120. Further, the offset orientation of the knife channel, e.g., knife channel 115 b, and the disposition of the knife blade 190 traveling through the knife guide 133 also enhances the cutting effect and reduces the chances of the knife blade 190 binding during translation (extension or retraction).
  • [0059]
    As mentioned above, when the jaw members 110 and 120 are closed about tissue, knife channels 115 a and 115 b form a complete knife channel 115 to allow longitudinal extension of the knife blade 190, from the knife path 138, in a distal fashion to sever tissue along a tissue seal. Knife channel 115 may be completely disposed in one of the two jaw members, e.g., jaw member 120, depending upon a particular purpose. It is also envisioned that jaw member 120 may be assembled in a similar manner as described above with respect to jaw member 110.
  • [0060]
    Referring now to FIGS. 6 and 8, electrical lead or wire 126 is shown extending from shaft 12 through knife housing 133 and entering wire tube 125 of jaw members 120. Wires 116 and 126 are used to supply electrical energy to electrically conductive sealing surfaces 112 and 122 of jaw members 110 and 120, respectively. In the embodiment of FIG. 6, knife housing 133 also acts as a wire guide, configured to guide wires 116 and 126 to jaw members 110 and 120. Electrical leads or wires 116 and 126 are protected by knife housing 133. Wire tube 125 (FIG. 8) of jaw member 120, may be offset from a longitudinal axis “Y” of the forceps 10 in the same direction as the offset knife channel 115 b, such that knife channel 115 b is disposed above the wire tube 125. The offset “X” of the knife channel, e.g., knife channel 115 b, and the offset “Y” of the disposition of the electrical lead or wire 126 relative to longitudinal axis “A” may be different or the same depending upon a particular purpose or to facilitate manufacturing. For example, as mentioned above, the offset distance “X” may be in the range of about 0.010 inches to about 0.040 inches whereas the offset distance “Y” may be in the range about 0.040 inches to about 0.140 inches. In addition, particular “X” and “Y” configurations may be as follows: When “X” is about 0.010 inches “Y” may be about 0.040 inches; when “X” is about 0.017 inches “Y” may be about 0.070 inches; and when “X” is about 0.034 inches “Y” may be about 0.140 inches. Other configurations and offsets for “X” and “Y” are also contemplated and within the scope of this disclosure.
  • [0061]
    Referring now to FIGS. 9-12, one embodiment of an end effector assembly 400 for use with forceps 10 includes a pair of jaw members 402, 404, a knife assembly 410, and a cam assembly 420.
  • [0062]
    One or both jaw members 402, 404 are moveable relative to the other about a pivot 440 operably associated with the forceps 10. One or both jaw members 402, 404 are moveable between an open position (FIGS. 9-11) and a closed position (FIG. 12) for grasping tissue. One or both of the jaw members 402, 404 include a knife channel 406 defined therein that extends therealong. One or both of the jaw members 402, 404 may be adapted to connect to an electrosurgical energy source to electrosurgically treat tissue.
  • [0063]
    The knife assembly 410 includes a knife blade 412 and an actuation shaft 414. The knife blade 412 may be affixed to a distal end of the actuation shaft 414. The actuation shaft 414 is operably associated with the knife trigger assembly 70 of forceps 10 (FIG. 1). The knife blade 412 is disposed distally relative to the pivot 440. The actuation shaft 414 is configured for slidable translation through the pivot 440 to allow selective advancement of the knife blade 412 through the knife channel 406 upon activation by the knife trigger assembly 70.
  • [0064]
    The cam assembly 420 is operably coupled to each moveable jaw member 402, 404 and is actuatable to move one or both jaw members 402, 404 between the open and the closed position for grasping tissue therebetween. The cam assembly 420 includes an actuator clevis 422 operably coupled to a support clevis 430 operably associated with the housing 20. The cam assembly 420 is configured to move one or both jaw members 402, 404 between the open and the closed position upon selective longitudinal translation thereof. The actuator clevis 422 may be moveable via an actuator tube 450 operably associated with the shaft 12 extending from the housing 20 to actuate both jaw members 402, 404.
  • [0065]
    The pair of jaw members 402, 404 are mounted to the support clevis 430 about the pivot 440. The support clevis 430 defines an actuator bore 432 and an actuator tube bore 434 for facilitating the slidable translation of the actuator clevis 422 and the actuator tube 450 therethrough. With reference to FIG. 9, cable channels 470, 472, etc. may also be defined through support clevis 430 for receiving one or more of the leads of the electrosurgical cable 310 (FIG. 1) therethrough.
  • [0066]
    The pivot 440 has first and second sections 442, 444 defining a passage 446 therebetween configured to permit the actuation shaft 414 to slidably translate therethrough. In some embodiments, the first and second sections 442, 444 of the pivot 440 are fixedly connected to the support clevis 430. The support clevis 430 is mounted to the distal end of the actuator tube 450. The actuator tube 450 is operably associated with the drive assembly 60 for longitudinally translating the actuator tube 450. The actuator tube 450 is configured to slidingly receive the knife assembly 410 therein.
  • [0067]
    The actuator clevis 422 includes one or more cam pins 424, 426 extending therefrom. One or both jaw members 402, 404 define one or more cam slots 403, 405 therein such that the one or more cam slots 403, 405 and the one or more cam pins 424, 426 are configured to cooperate with one another to move each moveable jaw member 402, 404. The actuator tube 450 is configured to longitudinally translate the actuator clevis 422 and permit the slidable translation of the actuation shaft 414 therethrough for facilitating the translation of the knife blade 412. The actuator tube 450 slidably translates along a knife tube 460 mounted to the pivot 440 between the first and second sections 442, 444.
  • [0068]
    The one or more cam pins 424, 426 are configured to slidably engage the knife tube 460 upon the selective longitudinal translation of the actuator clevis 422. The distal ends 424 d, 426 d of the cam pins 424, 426 are configured to slidably engage the outer surface of the knife tube 460. As illustrated in FIGS. 11 and 12, the distal ends 424 d, 426 d of the cam pins 424, 426 define a pin profile that may be generally crescent-shaped for cooperating with the generally circularly-shaped outer surface of the knife tube 460. The knife tube 460 and the pin profiles may have any suitable cross-sectional shape (e.g., circular or non-circular). The knife tube 460 defines a recess 462 adapted to mount each of the first and second sections 442, 444 of the pivot 440 at the distal ends 442 d, 444 d thereof. The distal ends 442 d, 444 d of each of the first and second sections 442, 444 define a profile configured to fixedly engage the recess 462. The profiles of both the distal ends 442 d, 444 d of the first and second sections 442, 444 define the passage 446 between each section 442, 444 for engaging the recess 462 of the knife tube 460. The passage 446 and the recess 462 may define any suitable cross-sectional shape (e.g., circular or non-circular). As illustrated in the embodiment of FIG. 11, the profiles of the first and second sections 442, 444 are each generally crescent-shaped to fixedly engage the circumferential groove that defines the recess 462 so that first and second sections 442, 444 provide a stationary pivot about which jaw members 402, 404 move.
  • [0069]
    In operation, upon actuation of the movable handles 30 a and 30 b, the drive assembly 60 slidably longitudinally translates the actuator tube 450 through the actuator tube bore 434 of the support clevis 430. The translation of the actuator tube 450 effectuates the longitudinal translation of the actuator clevis 422 through the actuator bore 432 of the support clevis 430. As the actuator clevis 422 translates, each cam pin 424, 426 slides within each respective cam slot 403, 405 and along the outer surface of the knife tube 460. When each cam pin 424, 426 translates through each respective cam slot 403, 405, the jaw members 402, 404 translate between the first position and the second position. In effect, each respective jaw member 402, 404 rotates about the pivot 440 in response to the longitudinal translation of the actuator clevis 422. Upon actuation of the knife trigger assembly 70, the actuation shaft 414 translates through the actuator tube 450 and the knife tube 460 such that the knife blade 412 is advanced through the knife channel 406 of the jaw members 402, 404.
  • [0070]
    With reference to FIG. 13, one embodiment of an end effector assembly 500 for use with forceps 10 includes a roll joint 510 secured to the distal end of the support clevis 430 and operably coupled to the actuator tube 450 for facilitating the rotational movement of the jaw members 402, 404. The roll joint 510 includes a stationary portion 510 a and rotatable portion 510 b. The stationary portion 510 a is fixedly coupled to the handle assembly 30. The rotatable portion 510 b is operably coupled to the stationary portion 510 a and the actuator tube 450. The rotatable portion 510 b includes one or more moveable interfaces 512 (e.g., one or more bearings, bushings, etc.) secured thereto. Each movable interface 512 is configured to permit relative rotation between the stationary portion 510 a and the rotatable portion 510 b.
  • [0071]
    In operation, the actuator tube 450 is rotated which, in turn, rotates the rotatable portion 510 b in response thereto. With the actuator tube 450 fixedly mounted to the rotatable portion 510 b and radially movable within the stationary portion 510 a, the actuator tube 450 transmits torque to the jaw members 402, 404 via the roll joint 510 upon the rotational movement of the actuator tube 450. In this manner, the jaw members 402, 404 may be radially rotated about the longitudinal axis “A” while the handle assembly 30 remains stationary.
  • [0072]
    With these embodiments, the distance to the pivot point is significantly reduced which facilitates assembly and ease of use. In certain embodiments, this shortened distance to the pivot point facilitates articulation of the end effector.
  • [0073]
    While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
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Clasificaciones
Clasificación de EE.UU.606/41, 606/167, 606/205
Clasificación internacionalA61B17/285, A61B18/14
Clasificación cooperativaA61B2018/00619, A61B2018/00595, A61B2018/00589, A61B2017/2947, A61B17/295, A61B17/2909, A61B17/29, A61B18/1482, A61B2018/00404, A61B2018/1432, A61B2018/1455, A61B2018/1412, A61B2018/0063, A61B2018/1861, A61B2017/2945, A61B2018/00601, A61B18/1445
Clasificación europeaA61B18/14F2
Eventos legales
FechaCódigoEventoDescripción
22 Ene 2010ASAssignment
Owner name: TYCO HEALTHCARE GROUP LP, COLORADO
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MUELLER, PETER M.;REEL/FRAME:023835/0876
Effective date: 20100122
2 Oct 2012ASAssignment
Owner name: COVIDIEN LP, MASSACHUSETTS
Free format text: CHANGE OF NAME;ASSIGNOR:TYCO HEALTHCARE GROUP LP;REEL/FRAME:029065/0403
Effective date: 20120928
28 Dic 2016FPAYFee payment
Year of fee payment: 4